Organization
ALAMITOS DERMATOLOGICAL MEDICAL CLINIC A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA T DENNIS (ADMINISTRATOR)
(562) 619-8440
Entity
Organization
Contact information
Practice address
12721 NEWPORT AVE, SUITE 4, TUSTIN, CA 92780-8030
(714) 838-5680
(714) 544-1321
Mailing address
12721 NEWPORT AVE, SUITE 4, TUSTIN, CA 92780-8030
(714) 838-5680
(714) 544-1321
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/09/2007
Last updated
02/25/2016
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